Individual provider Active NPI

Mark Holaday

  • Occupational Therapist
  • Boulder, CO
National Provider Identifier
1295226488
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-0005224 Issued in CO
Practice address
1895 Bluff St Apt a
Boulder, CO 80304-4286
Phone
(720) 435-4341
NPI assigned
May 23, 2018
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-0005224 CO Primary

Addresses

Primary practice location

1895 Bluff St Apt a
Boulder, CO 80304-4286

Mailing address

1895 Bluff St Apt a
Boulder, CO 80304-4286
Phone (720) 435-4341

Other identifiers 1

IdentifierTypeStateIssuer
51005356904OtherWIPHYSICIANS PLUS INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT-0005224COMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Feel Play Grow Occupational Therapist CurrentSince Jan 7, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1295226488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 BLUFF ST APT A",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044286",
            "telephone_number": "720-435-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 BLUFF ST APT A",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044286",
            "telephone_number": "720-435-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLADAY",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "OT-0005224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS PLUS INC",
            "identifier": "51005356904",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.